Things you may want to know before your first visit

In an effort to keep our services at the most affordable price, we have continued to remain on most insurance panels and are in-network providers. Upon your first visit, our care manager will determine your insurance coverage and your out of pocket costs for any services we provide. To acquaint yourself with the complexities of insurance coverage, you may want to review some of our blogs on this topic.

For most commercial insurances, the first visit is a covered service and does not require a referral.

You are welcome to bring a significant other to your visit.  Many people want to do this so that we can get as much background information as possible.  If you are coming to learn about services for a child, we welcome all ages, but will also meet with parent(s) alone if they feel it would not be beneficial to have the child along.

For all patients, we will ask for the information on this form. It can be completed and brought with you, or you can complete it in the office when you arrive.

Are you using insurance?

If you are using insurance, these additional forms will need to be completed:

How to confirm insurance coverage for testing

As you may know, insurance coverage can be complicated.  We hope the following information is helpful to help you to navigate the terms of you insurance plan.

Most insurances include coverage for the initial visit (copays and deductibles apply) pay for a portion of your testing.

Most insurances cover a portion of psychological testing. If testing is recommended by your psychologist, we will obtain information about your coverage following your initial appointment.  If an evaluation is recommended, it is suggested you telephone your insurance company at least a week before your evaluation to obtain information about what your plan covers, not only to determine coverage, but also to determine if your plan requires pre-certification.  Most plans have two components:  outpatient behavioral/metal health and medical benefits   Following are two sets of questions to ask for each benefitKeep in mind that when the representative quotes you coverage, this does not necessarily mean they will reimburse you for the whole cost. Co-pays, co-insurance and deductibles will reduce the amount the insurance pays, even if it is a covered service.

If you have a HSA account, it will reimburse for the fees “allowed” by insurance, as well as other costs, if they are medically related.

Please note that insurance companies do this type of verification Monday-Friday. Most are open 8 am until 4:30 pm.  The entire process can go as quickly as 15 minutes and as long as 45 minutes

  1. Is pre-certification required for psychological testing.   If yes, How is pre-certification obtained?
    1. ______ Insurance company requires provider to telephone to obtain pre-certification.

_____________ telephone number for provider to call to obtain pre-certification. This must occur prior to the date of your scheduled            evaluation.

2.______ provider needs to submit written documentation for pre-certification. This must occur at least one week prior to scheduling.

If this is the case,

  • ask the representative how to obtain the form the provider needs to complete. (they usually can fax it to you)
  • if a written form needs to be submitted, ask the representative if it can be submitted on the same date as the testing. Usually this is not possible, and you will need to come in for a separate appointment prior to the evaluation to provide information that allows the provider to complete the form.
  1. Are there diagnostic exclusions? _____yes  ____ no

You may be asked for a diagnosis, which can be provided to you by our office following your first appointment.ment

  1. Is there a deductible? ______yes _______no

If yes, what is the amount? $__________

 

  1. What portion of the deductible has been met? $________

 

  1. What is the co-insurance? _______%

 

  1. What is the copay? $______

 

  1. Where does the claim get sent? ________________________________

Name of representative that you spoke with: ____________________

Reference number for the call: ___________________

 

Date:  ­­­­­____________________

 

 

It is important to get the name of the representative and a reference number for the call. This will serve as your record, should there be a discrepancy between what you were told and what the insurance ultimately pays.

If you do not provide this information at the time of your testing, we will submit your claim, but it may not be paid if precertification is required and were not notified by you that this is required.

Understanding your Condition is Our Mission

Appointments are Available.